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A guide to understanding mental health

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ContentsTable of

UNDERSTANDING MENTAL HEALTH 4Stress: Friend or foe? 4

Anxiety disorders: When stress becomes a condition 8

Generalized anxiety disorder (GAD) 9

Panic disorder 10

Phobia 11

Obsessive-compulsive disorder (OCD) 11

Post-traumatic stress disorder (PTSD) 13

Depression 16

Seasonal affective disorder (SAD) 20

Burnout 21

STRATEGIES FOR MAINTAINING GOOD MENTAL HEALTH 24Maintaining healthy lifestyle habits:

The first step on the road to mental health 24

Consulting a health professional: The all-important next step 26

A practical, five-step problem-solving tool 28

Mental and physical well-being through relaxation 32

Abdominal breathing in six steps 33

Understanding

mental health

STRESS: FRIEND OR FOE?Stress is essential to human survival. It is an innate warning mechanism that gives you the extra endurance, speed, and focus needed to take on real or perceived threats. Your senses become heightened and your body springs into action, ready to respond to a dangerous situation:

> Your heartbeat quickens> Your breathing accelerates> Your muscles tense> Your pupils dilate> You transpire more

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But stress isn’t just a response to danger. You may also experience it in everyday situations, like having to speak in front of an audience or find a last-minute babysitter.

WHAT ARE THE MOST COMMON STRESSORS?

You deal with stressful situations every day. They may be real (for instance, you lose your job), potential (your company announces upcoming job cuts), or perceived as real (“I can’t make a single mistake at work!”). Stress agents—or stressors—can be positive (such as the birth of a child) or negative (the death of a loved one). Stressors are usually a sign that something in your life has to change, and they can be linked to a variety of causes, including:

> Injury> A lack of sleep> Perfectionism> Moving> A lack of time> And more

Our capacity to handle whatever life throws at us varies from person to person. Situations can be stressful to varying extents depending on the individual, past experiences, and the stage of life in which the event occurs.

A guide to understanding mental health 5

WHEN STRESS BECOMES CHRONIC

Chronic stress is not the same as acute stress, which is your body’s way of preparing for a situation that is usually isolated and temporary. Some acute stress is actually good for you because it helps you perform better when you need it most.

Did you know that about one out of five Canadians say

they aren’t getting enough sleep? Sleep deprivation has a negative impact on your mental and physical health.

It can cause unpleasant symptoms like stress,

moodiness, and impaired concentration. Creating a calm

environment, establishing a regular bedtime routine,

and adopting healthy habits can significantly improve the

quality of your sleep.

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Chronic stress, on the other hand, is prolonged and intense and may put your health at risk. It generally sets in when you feel unable to cope with the demands being placed on you, making your body go into constant alert mode.

Chronic stress can take a psychological toll, causing depression, and a physical toll, causing pain and even heart disease. Longterm exposure to stress can simply wear your body down.

The fast-paced, unhealthy North American lifestyle—characterized by poor diet, a lack of sleep, and unreasonable expectations for performance and success—can set the stage for chronic stress.

CAN YOU REALLY MANAGE CHRONIC STRESS?

Absolutely! Gaining the upper hand starts with identifying the major stressors in your life. This makes it easier to find ways to resolve and eliminate those things that cause you undue stress. It’s also important to carve out downtime every day. The second part of this booklet offers some practical tools and guides you through the stress management process step by step.


ANXIETY DISORDERS: WHEN STRESS BECOMES A CONDITIONChronic stress should not be confused with an anxiety disorder, which may cause stress but can’t necessarily be linked to your lifestyle. Anxiety disorders are mental health conditions that can happen at any time and may not always have an identifiable trigger.

There are, however, certain factors that may increase your risk of developing an anxiety disorder:

> Your genetics and family history may make you more sensitive and prone to stress.

> Certain health conditions, like thyroid disease, may be predisposing factors.

> Drug or alcohol abuse put you at risk.> Social, family, or work-related stressors can contribute.> Your natural temperament may incline you to put yourself down

and have difficulty adapting to change.

It doesn’t have to be this way forever. There are a range of drug therapies and psychotherapies that can help you feel better. If you are struggling with anxiety, it’s important to discuss your concerns with a health professional. Here’s a look at some of the most common anxiety disorders.

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GENERALIZED ANXIETY DISORDER (GAD)

Generalized anxiety disorder is defined by excessive fears that are difficult to control and have been present for at least six months. Sufferers have unfounded worries—usually exaggerated and unrealistic—about routine aspects of daily life not usually considered stressful. Those with GAD tend to imagine the worst-case scenario.

For instance, they may fear their house is going to burn down whenever they leave home, even though the likelihood of that happening is slim.

People with generalized anxiety disorder can be highly irritable, keyed up, tense, and easily exhausted. They usually have difficulty concentrating and getting a good night’s sleep.

GAD is one of the most common anxiety disorders, affecting 5% to 10% of the population. Women experience generalized anxiety disorder twice as often as men.


PANIC DISORDER

Panic disorder is characterized by a sudden feeling of intense fear that strikes without reason, coming to a head within minutes. People having a panic attack are overcome with a feeling of impending doom that has no logical explanation but seems so vividly real, it keeps them from going about their normal lives. Panic attacks may cause heart palpitations, shortness of breath, a perceived loss of control, and excessive sweating.

For instance, someone standing in line at the grocery store may suddenly become convinced that the business is going to be robbed at gunpoint, and get the uncontrollable urge to flee the scene.

After the episode has subsided, the person might be left with a lingering fear that it will happen again and decide to avoid the store at all costs.

When people end up avoiding public places to head off a panic attack, it is known as panic disorder with agoraphobia.

Panic disorder with or without agoraphobia affects approximately 1% to 4% of the population and is more common in women. It can strike at any age, but usually in the late teens through the mid-thirties.

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PHOBIA

A phobia is an unreasonable, uncontrollable fear of a particular thing—it could be an object, a situation, an animal, or anything else. Being afraid of certain things is normal. What makes a phobia different is the sufferer’s exaggerated, persistent, and crippling reaction to whatever triggers their terror.

Phobia sufferers might even avoid certain situations or places for fear of having to face the thing that scares them. Fear wins out over common sense, and their phobia becomes so all-consuming that it interferes with daily life. People with a phobia are aware of their fear but unable to pinpoint the exact cause.

OBSESSIVE-COMPULSIVE DISORDER (OCD)

As indicated by its name, obsessive-compulsive disorder has two aspects: obsession and compulsion. Obsession is repetitive, inappropriate thinking directed at a specific thing that you can’t get out of your mind. Compulsion is a recurring, irresistible urge that takes the form of a ritual that helps alleviate the obsession.

About 7% to 11% of the population will suffer from some sort of phobia during their lifetime, and women are twice as vulnerable as men.


People with obsessive-compulsive disorder have both an obsession and a compulsion that prevent them from leading normal lives, causing severe anxiety and distress. OCD sufferers can waste large chunks of their day carrying out their compulsive rituals.

They might be terrified at the thought of catching a deadly disease from shaking hands, touching an object, or using a contaminated surface. The obsession involves a fear of getting sick through hand contact. To help relieve the fear, they engage in compulsive behaviour, washing their hands repeatedly and taking multiple showers throughout the day. They believe they can prevent a fatal illness by washing their hands with soap. OCD sufferers are usually well aware that the likelihood of catching a deadly disease from a grocery cart handle is slim to none, but their obsession becomes so all-consuming, they lose sight of common sense. They are forced to relieve their obsession before they can go about their normal day.

This disorder affects 2.5% of the population and tends to be equally common in men and women.

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POST-TRAUMATIC STRESS DISORDER

Post-traumatic stress disorder (PTSD) is the development of specific symptoms following an especially harrowing event, like a physical assault, fire, or car accident. The symptoms point to underlying mental distress that can take many forms. Some sufferers become withdrawn, others anxious, and others experience persistent terrifying thoughts. Symptoms usually appear within three months of the traumatic experience, but onset may be delayed in some cases.

Imagine someone is in a near-fatal car accident. In the weeks following the incident, that person might avoid vehicles altogether and become increasingly disengaged and unable to function in social situations.

An estimated 1% to 15% of the population suffers from this disorder. It is important for PTSD victims to talk about their trauma and avoid shutting everyone out.


HOW CAN I TELL IF I HAVE AN ANXIETY DISORDER?

Health professionals use a highly specific set of criteria to diagnose anxiety disorders. To get proper treatment, it’s important to see a professional if you think you might have one.

CAN ANXIETY BE TREATED?

YES! A number of treatments have been proven effective for anxiety-related issues, helping sufferers get relief from their worries and resume their normal lives. Two of the most common treatments are cognitive behavioural therapy (CBT) and drug therapy.

Cognitive behavioural therapy is a combination of psychological strategies aimed at helping people gain control over their anxiety. Strategies include:

> Psychoeducation: Professionals educate and inform patients on their condition to help them better understand it.

> Exposure: Patients are exposed to an anxiety-producing situation in an effort to gradually desensitize them to it (regularly used with phobias and OCD).

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> Cognitive restructuring: Patients learn to become aware of their irrational thoughts and replace them with positive ones.

> Breathing exercises: Patients learn the right way to breathe in a crisis situation to reduce anxiety and avoid hyperventilating. The second part of this booklet provides a deep breathing exercise.

> Problem solving: Professionals guide patients through a series of questions to guide them toward finding solutions to their anxiety issues. A problem-solving tool is presented in the second part of this booklet.

> Muscle relaxation: Patients are taught how to relax to alleviate muscle tension and anxiety. The second part of this booklet also offers relaxation techniques.

Different classes of drugs may be prescribed along with cognitive behavioural therapy to help patients feel better and reduce their anxiety long term.

Ultimately, maintaining a healthy lifestyle is the basis for good mental health. The second part of this booklet gives you some tips on healthy living.


DEPRESSION Clinical depression, or major depression, is a mental health condition that 15% to 20% of Canadians will experience during their lifetime. Contrary to popular belief, being depressed is not the only symptom of depression. People with depression may also experience pain, nausea, difficulty concentrating, sadness, and other symptoms. It’s impossible to pinpoint the exact cause of depression, but there are certain clear risk factors. Major depression can be linked to:

> A family history of depression> Childhood trauma> Drug or alcohol abuse> Stressful events (for instance, the death of a loved one)> Hormonal changes (e.g., pregnancy or menopause)> Other mental health issues (for example, anxiety disorder)> And more

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The symptoms of major depression may vary from person to person, but the most prevalent include:

> Depressed mood every day> Loss of interest or pleasure in almost all activities> Change in weight or appetite> Sleep disturbance> Behavioural changes (agitation, nervousness, sluggish reflexes)> Fatigue or lack of energy> Feelings of worthlessness or excessive guilt> Difficulty concentrating and brain fog> Suicidal thoughts> And more

Note that someone who experiences one depressive episode is at a higher risk for a second episode during his or her lifetime.


“I WISH I WERE DEAD”

Suicide is a complex, multifactorial issue that 80% to 90% of the time occurs due to an underlying mental health condition like depression. Suicidal thoughts may seem harmless on the surface, but it’s important to take them seriously and act quickly. If you are contemplating suicide or are close to someone who is, please get help. Discuss it with a friend or family member, consult with a health professional, or place a confidential call to your local suicide prevention centre at 1-866-277-3553.

HOW DO I KNOW IF I’M DEPRESSED?

To be treated properly, depression must be diagnosed by a health professional. It’s important to see someone if you think you’re experiencing a depressive episode.

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OVERCOMING DEPRESSION

There are a number of effective treatments to alleviate symptoms of depression. The first step is to talk to a health professional who can point you toward getting the help you need. Psychotherapy and drug therapy are the two most common treatments for depression.

There are two treatment strategies in psychotherapy—cognitive behavioural therapy (CBT) and interpersonal therapy. The goal of CBT is to change the thoughts or behaviours that trigger your depression, while interpersonal therapy aims to improve your relationships with others when you are depressed.


SEASONAL AFFECTIVE DISORDER (SAD) Seasonal affective disorder, commonly known as seasonal depression, is a type of depression generally associated with the lack of natural light during winter. It is more common in northern countries like Canada. One out of four people experience mild or moderate symptoms of seasonal depression, which usually starts in the fall or late winter and fades in the spring.

People with SAD may feel tired and down, have difficulty concentrating, and need more sleep than usual. To help alleviate their symptoms, it is recommended they walk from 30 to 60 minutes every day during the daylight hours (e.g., in the morning) and engage in regular physical activity. Some people may experience more severe symptoms not unlike those of major depression.

If you believe you may have seasonal depression, don’t

hesitate to talk to your health professional.

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BURNOUTAt least one in four Quebecers cite high levels of stress in their daily lives, a ratio that can jump to one in two in certain job fields.

Professional exhaustion syndrome, also called burnout, is a state of intense fatigue, withdrawal, and reduced productivity due to chronic stress at work. Unlike depression, which affects every aspect of the sufferer’s life, burnout is directly linked to work. Burnout most often occurs after a prolonged period of exposure to chronic workplace stressors like:

> An excessive workload> A lack of autonomy in decision-making> A lack of recognition by coworkers and superiors> Insufficient social support> Difficulty communicating with peers> And many others


A certain amount of stress can be professionally beneficial—it can boost your productivity and motivate you in your job. But when you are too stressed too much of the time, it can have a negative impact and lead to burnout. When that happens, your performance tends to plummet, giving way to distress. The graphic below illustrates the concept.

Good stress Distress

FatigueFeeling overwhelmed

Exhaustion

Bad health

Depression

Performance

Physical arousal (stress)

Comfort zone

Healthy tension

Stess and performance curve

In other words, it’s important to find a balance to maintain a healthy level of productivity.

Adapted from Nixon, P.G.F. (1976). The human function curve. Practitioner 217:935-944.

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WHAT IS THE WINNING RECIPE FOR JOB SATISFACTION?

Burnout usually sets in when our work environment isn’t aligned with our needs. Everyone is different, and a workplace that is good for one person may not be for someone else.

The following factors are important ingredients in feeling good at work:

> Having a workload you can handle that’s within your area of expertise.

> Having the resources and tools you need to fulfill your responsibilities (a feeling of control).

> Being rewarded for the work you do (recognition).> Having a sense of belonging to your work group.> Having a fair workplace that fosters self-esteem.> Having a workplace that shares your personal values.

Burnout symptoms that go untreated may lead to major depression, so it’s important to talk to your health professional if you think you may be experiencing professional exhaustion.


Strategies for maintaining

good mental health

MAINTAINING HEALTHY LIFESTYLE HABITS: THE FIRST STEP ON THE ROAD TO MENTAL HEALTHHealthy lifestyle habits can mean many things, including:

> Taking the time to eat well.> Going to bed at a reasonable time so you get enough sleep.> Getting regular exercise.> Reducing your consumption of coffee and alcohol.> Quitting smoking.> Maintaining positive relationships with the people around you.> Participating in pastimes you enjoy.> Seeking out support during difficult times, like the death

of a loved one.> And many others.

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Healthy habits are the best way for you to stay in top physical and mental form. It’s important to take stock from time to time to determine which habits you want to change or improve. To boost your odds of success, try to change only one lifestyle habit at a time, starting with something simple and attainable. If you decide to quit smoking, eat better, and exercise four times a week at the gym all at once, you are less likely to succeed than if you start with a 15-minute walk four times a week and ramp up gradually.

Humans are creatures of habit. It takes at least three to six months for a new behaviour to become part of your routine, but with time, it will require less effort and will be easier to maintain. Don’t be shy—enlist your friends and family to help you stay motivated! You can also find a way to reward yourself every week for all your hard work. Adopting healthier lifestyle habits only works to your advantage. It’s up to you to set realistic goals and challenge yourself to meet them!


CONSULTING A HEALTH PROFESSIONAL: THE ALL-IMPORTANT NEXT STEPMany people are reluctant to discuss psychological issues with a health professional because they wrongly believe things like:

> “I’m making something out of nothing—it’s not that bad!”> “It’ll go away on its own.”> “I’m afraid of being judged.”> “My health professional is there for physical problems; I don’t

want to bother her with my personal issues.”

It’s important to realize that healthcare professionals:

> Believe that mental health problems are just as important as physical health problems.

> Understand that mental health problems rarely resolve themselves; instead they tend to worsen and become more complex over time.

> Will be open-minded and empathetic about mental health problems rather than judgmental.

> Are professionally bound by confidentiality, which means the information you disclose cannot be shared with anyone else.

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WHAT IF MY DOCTOR PRESCRIBES ME SOMETHING?

You may need medicine to alleviate your symptoms. Be sure to follow the instructions on the prescription label because some drugs have to be taken consistently every day to be effective. Don’t get discouraged if you don’t see an immediate change in your mood. Many medications take several weeks to reach their full effect.

Your health professional may gradually increase your dosage depending on the drug’s effectiveness and your tolerance. Some medications may not alleviate your symptoms or may cause undesirable side effects. It’s important to discuss all this with your health professional. It might take a few tries before you find the drug that’s best for you.

Lastly, it is usually not a good idea to stop taking a medication abruptly. Your body may have gotten used to it and could have a negative reaction if you stop suddenly. Talk to a health professional to make a plan to come off the drug gradually.


A PRACTICAL, FIVE-STEP PROBLEM-SOLVING TOOLProblem solving is a practical and concrete strategy to help you manage difficult situations and make informed decisions. It’s a way to take action rather than just worry about what might happen. Problem solving can save valuable time and make your life easier.

1. WHAT IS THE PROBLEM?

You may know you have a problem, but it seems vague (for instance, “I don’t have enough time to do everything I need to.”). To gain control over the situation, it’s important to put the problem into concrete terms, e.g., “I don’t have time to cook dinner when I get home.” When you understand exactly what’s wrong, you’re well on your way to solving it.

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2. WHAT CAN I DO ABOUT IT?

This is what we commonly call “brainstorming.” Get some paper and a pencil and write down every idea that comes to you, no matter how far-fetched it may seem. At this stage it’s important to silence your internal editor and let your imagination run free. Any possible solution, whether good or bad, might be an option to consider. For the example in Step 1, your list of potential solutions could include:

> Preparing your meals on Sunday

> Buying prepared meals

> Asking your spouse to help out


3. PROS AND CONS

Go over each solution and assess the pros and cons. To properly evaluate a solution, ask yourself how feasible, useful, and beneficial it is. For example, asking your spouse to help out would be beneficial because it wouldn’t cost anything, and it would be useful because it would free up some time, but it wouldn’t be very feasible if he or she doesn’t get off work until 6:00 p.m.

4. CHOOSING THE RIGHT SOLUTION

After assessing each potential solution, it’s time to move on to the decision stage. Consider combining multiple solutions—for instance, you could cook a few meals on Sunday and buy prepared meals for the rest of the week.

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5. DOES MY SOLUTION WORK?

Once you’ve made your decision, the most critical step is putting it into action. Implementing a practical solution in your daily routine can only make things better, but after a few weeks you should re-evaluate its effectiveness. If it’s not working, don’t lose hope. Go through the steps in this booklet again and try something else.

Trying something new is always

better than doing nothing at all!


MENTAL AND PHYSICAL WELL-BEING THROUGH RELAXATION Relaxation can be achieved from a range of pleasant and calming activities that are not overly demanding physically, mentally, or socially. It’s a good idea to create your own list of activities you find relaxing, which might include:

> Taking a hot bath> Going for a walk> Hanging out in bed> Doing yoga> Meditating> Practicing visualization> Stretching> Listening to music> Reading> Having a cup of tea> And many others

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There’s nothing wrong with giving yourself 30 to 60 minutes of downtime

a day. Taking this time for yourself can give you more mental and physical

energy and help you manage your stress.

ABDOMINAL BREATHING IN SIX STEPSWe come out of the womb practicing abdominal breathing. Belly breathing is slow, deep, steady, and voluntary—meaning we are the ones who initiate it. It induces a feeling of well-being, calm, and relaxation. When we don’t focus on breathing deeply, we unconsciously practice thoracic (or chest) breathing, which is rapid, superficial, and erratic.


Abdominal breathing comes naturally—it’s like riding a bike! It also offers a number of benefits:

> It boosts your physical and mental health.

> It reduces muscle tension.

> It’s free.

> You can practice it anywhere.

> No one can tell.

> All it takes is five minutes twice a day.

> There are no ill effects.

> Anyone can do it, whatever their age, gender, or physical condition.

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ABDOMINAL BREATHING IN SIX STEPS:

1Find a comfortable position sitting or lying down with your arms and legs straight.

2Put one hand on your belly and the other on your chest, and take a minute to tune in to your breathing.

3Take a deep breath through your nose for about three seconds, focusing on sending the air down to your belly. Imagine inflating it like a balloon, then exhale slowly through your nose or mouth for a five-second count.


6Practice abdominal breathing during times of stress. Once you’ve mastered it in relaxing and routine situations, you’ll be able to use it to help you stay centred and calm when you’re feeling stressed.

4Practice abdominal breathing when you are relaxed—for instance, while listening to quiet music or visualizing a place that makes you feel calm.

5Practice abdominal breathing while going about your day. Once you’ve mastered the technique in relaxing situations, you’ll be able to practice it any time without having to put one hand on your chest and one on your belly.

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Exhale

At rest you take 14 to 20 breaths per minute. Using abdominal breathing, you can learn to take 10 to 14 breaths per minute, which is easier on your body and calms your mind. Over time and with practice, you will begin to naturally breathe this way without even thinking about it.

Breathe in deeply through your nose for about three seconds. Concentrate on

sending the air to your belly rather than your chest.

Inhale

Exhale slowly and steadily through your nose

or mouth for five seconds or longer.


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ConclusionDon’t forget that taking care of your body and your mind is the foundation of good mental health. If you have concerns about your mental health, talk to your health professional right away.

HELPFUL RESOURCES> Info-Santé: 811> Suicide prevention centre: 1 866 APPELLE (277-3553)> Crisis centre: www.centredecrise.ca> Canadian Mental Health Association: www.cmha.ca> Mental Illness Foundation: www.fondationdesmaladiesmentales.org> Quebec Anxiety, Depressive and Bipolar Disorder Support Association:

www.revivre.org> Association/Troubles de l’Humeur et d’Anxiété au Québec: www.ataq.org> Canadian Sleep Society: www.http://scs-css.ca/> American Psychological Association (APA). Diagnostic & Statistical Manual

for Mental Disorders> Québec Government, Portail Santé: www.sante.gouv.qc.ca> Institut universitaire en santé mentale de Québec: www.iusmm.ca> www.passeportsante.net

Bibliography: CANADIAN MENTAL HEALTH ASSOCIATION. Mental Health for All, [online], 2015. http://www.cmha.ca/mental-health/

MINISTÈRE DE LA SANTÉ ET DES SERVICES SOCIAUX DU QUÉBEC. Santé mentale, [online], 2015. www.msss.gouv.qc.ca

INSTITUT UNIVERSITAIRE EN SANTÉ MENTALE DE QUÉBEC. Maladies mentales, [online], 2015. www.institutsmq.qc.ca

INSTITUT UNIVERSITAIRE EN SANTÉ MENTALE DE MONTRÉAL. Santé mentale, [online], 2015. www.iusmm.ca

PASSEPORTSANTÉ.NET. L’épuisement professionnel (Burnout), [online], 2014. www.passeportsante.net

Maslach, C.; Schaufeli, W. B. and Leiter, M.P. (2001). Job Burnout, Annual Review of Psychology. 52: 397–422

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IN THIS GUIDEUNDERSTANDING MENTAL HEALTH Stress: Friend or foe? Anxiety disorders: When stress becomes a condition

Generalized anxiety disorder (GAD)Panic disorderPhobiaObsessive-compulsive disorder (OCD)Post-traumatic stress disorder

Depression Seasonal affective disorder (SAD) Burnout

STRATEGIES FOR MAINTAINING GOOD MENTAL HEALTH Maintaining healthy lifestyle habits:

The first step on the road to mental healthConsulting a health professional:

The all-important next stepA practical, five-step problem solving toolMental and physical well-being through relaxationAbdominal breathing in six steps

Cultivating mind - Familiprix · People with generalized anxiety disorder can be highly irritable,...

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Transcript of Cultivating mind - Familiprix · People with generalized anxiety disorder can be highly irritable,...